Hard Time to Harden?
Closer Look at Erectile Dysfunction
By PePe A. C.

ALL AGES. Not everyone wants to talk about it, mainly because it's embarassing (and talking about the penis is still largely taboo in society), but erectile dysfunction affects many men of any age.

It was, says A. Doctolero, the most embarrassing thing to have ever happened to him.  “I picked someone up from (a club along Makati Avenue in Makati City), and we headed to my place.  That was the easy part.  But we were in the middle of doing it (having sex, you know), when suddenly, there it went, my dick went limp.  That was the hard – and really embarrassing – part,” he says.  “Things like this don’t happen to someone like me – I’m just 21, for goodness’ sake!”

What happened to Doctolero, however – what’s called erectile dysfunction (ED), or the inability to achieve and sustain an erection suitable for sexual intercourse, according to webmd.com – is actually more common than earlier thought.

It permanently affects approximately 5% of 40 year old men (40% of the same age group experience ED at least occasionally), up to 25% of 65 year old men, and about 70% of men in their 70s or over, according to the National Institute of Health. 

Here’s the biggest news: Younger men, including 21 year old sexually active gay men like Doctolero, are actually not exempted, even if the ED only “affects the majority of men at some point in their life (through) the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired,” webmd.com states, adding that an estimated one in every 10 adult males suffer from some degree of ED.

An even bigger news, mainly because it’s a good news: The failure to get erect less than 20% of the time is not unusual, and so treatment is rarely needed.

WHY, OH WHY?

For the penis to get hard, three conditions has to occur: “The nerves to the penis must be functioning properly; the blood circulation to the penis must be adequate; (and) there must be a stimulus from the brain.  If there is something interfering with any or all of these conditions, a full erection will be prevented,” webmd.com states.
Thus, considered among interferences are those that affect proper blood flow, especially to the penis, medical conditions such as atherosclerosis or the hardening of the arteries; nerve diseases; and a condition called Peyronie’s disease (caused by scar tissue, called plaque, that forms along the length of the penis in the corpora cavernosa, and, depending on the severity of the condition, can cause the penis to bend, making sexual intercourse difficult and occasionally painful, states webmd.com).

Interestingly, some medications actually cause ED, too.  These include diuretics and antihypertensives; antidepressants, anti-anxiety drugs and antiepileptic drugs; antihistamines; non-steroidal anti-inflammatory drugs; and muscle relaxants.
Psychological factors also cause ED, said to be responsible for about 10% to 20% of all ED cases, with the most common including stress (include worries on penis size), anxiety (including performance anxiety), guilt (say, if/when cheating), depression (feelings of better to cry than to cum), low self-esteem (adding to stress), or indifference (lack of wanting sex could mean the death of it).

And then, there are lifestyle-related causes of ED, including excessive weight (obesity), smoking, drug use, and alcoholism.  Doctolero himself recalls “having drunk too much,” he says, “I was feeling all jelly-like.”  Obviously, if alcohol can incapacitate the other parts of the body, why not the penis, too?

Again, stresses webmd.com, since “all men at one time or another will experience ED, only if the problem becomes persistent (i.e. occurs more than 50% of the time), or becomes a source of distress for you or your partner should you be concerned and consider seeking medical/psychological advice and treatment.”

WHAT NOW?

When EDs regularly recur, a check-up is, without a doubt needed, particularly since ED, while not a deadly disease, may actually be a sign of other deadly health problems.  “Dependable erections are not necessarily a sure sign of excellent health, but a penis that won't rise to the occasion is a warning that something may be awry,” webmd.com states, quoting Ira Sharlip, MD, a urologist in San Francisco inthe US, and past president of the Sexual Medicine Society of North America.
Among the possibly fatal medical conditions that ED portend include any form of cardiovascular diseases, atherosclerosis or hardening of the arteries, and high blood pressure – all affecting the blood vessels, which may be why there’s an abnormal flow of blood to the penis.

This is not, however, to say that people with, say, heart problems are impotent, and vice versa; just that the probability is there, and may be worth taking a closer look at.

Other possible worrisome medical conditions also possibly foretold by ED include low testosterone levels (may be caused by, among others, problems with the pituitary glands, liver problems, and thyroid abnormalities); diabetes (which can damage nerves, thereby affect blood flow); and HIV (the virus and the treatments can cause neuropathy, thereby affecting nerves and blood flows, too).

Why not just Viagra to remedy the situation?  Not recommended, since “impotence isn't a problem that exists in a vacuum; and although the drugs to treat it appear to be safe for most men, doctors believe they need to keep a close eye on those who are taking them,” webmd.com states.

A visit to a doctor usually dictates the type of treatment (if/when needed) to be given to a man experiencing ED – these include oral medications (Viagra, of course, as well as Cialis and Levitra – all working to increase blood flow to the penis, with the differences largely to do with how quickly and the length of duration of effect); suppositories; and vacuum pumps (yes, penis pumps).

Nonetheless, it’s still best to talk to a doctor when ED is already a source of worry – and a basic way to know if it already is a source of worry, according to webmd.com, is to “measure nocturnal tumescence.  This involves wrapping a strip of paper or tape around the flaccid penis at night.  If the strip is broken in the morning, an erection likely occurred during sleep and impotence is most likely a psychological one.  When the problem is psychological, the underlying depression or anxiety is what should be treated.”

As for Doctolero, he’s considering cutting his alcoholic consumption “to see if it’s what caused me to not perform that night – I mean, I never had problems before that, after all,” he says.  “And then, I guess, I’ll take it from there.”